Crush Syndrome: Definition, Symptoms & Treatment

Instructor: Emily Smathers
Injuries are always traumatic. Thankfully, modern medicine has evolved to allow patients the best chance at recovering from even potentially fatal injuries such as crush syndrome. This lesson will define the condition, outline its history, and identify its symptoms and treatment.

Medical Progress

We are very lucky to live in a time when most medical conditions, diseases and injuries alike, can be treated pretty effectively. For example, it was not so long ago when an injury such as a snake bite would have been fatal. Now, however, we have anti-venoms available to treat many types of snake bites, making it no less painful, but far less fatal.

Not all diseases and injuries, however, have made such significant progress. Some injuries, such as the focus of today's lesson, are better understood, but no less traumatic or dangerous. In this lesson, we will define crush syndrome and identify causes, symptoms, and treatment of this type of potentially fatal injury.

Definition, History, and Symptoms

Crush syndrome is a life-threatening condition that requires urgent care, the result of extreme pressure on the body over an extended amount of time following a great compression or crush injury. It is what happens to the body when one or more body parts are held in a compacted state; it is the bodily response to that state. The effects of extreme compression or compaction to the body can be quite disastrous.

The syndrome was first well defined by a physician by the name of Dr. Eric Bywaters, following the treatment of a number of patients injured in the 1940 London Blitz. Because of his contributions to the identification and publication of the condition, it is frequently called Bywater syndrome, despite the fact that it had been described by physicians attending victims of catastrophes and wars in previous decades.

There are a number of other names for the condition, including compression syndrome, muscular necrosis compression, and traumatic rhabdomyolysis. Thankfully, it is a rare injury, seen only during extreme circumstances that put the body under great pressure, such as following a car crash, when a person becomes pinned under the car for an extended amount of time.

When the human body is trapped by a huge weight, the pressure on the bones, organs, surrounding tissue, and cells is enormous. Regular bodily fluid movement is interrupted. Without the ability to flow freely, bodily fluids such as blood, water, and toxins build at the site of injury. Such pressure causes extreme swelling in the trapped body part, be it the abdomen, in the legs, or in the arms. Additionally, such pressure is often accompanied by broken bones, lacerations, and/or burns that make the injury all the worse and increase blood loss and the chance of infection.

Treatment of Crush Syndrome

In regards to the treatment of crush syndrome, there is good news and bad news. The bad news is mortality, or the chance of death, for the condition is rather high, depending on the amount of time that the body is trapped and the pressure that builds. The good news is that since its first description, treatments for crush syndrome have developed and continue to develop that improve patient outcomes.

The treatment of Bywater syndrome focuses on managing the injuries. During evaluation, a crush syndrome victim's injuries are specified and prioritized.

It starts in the field with large infusions of appropriate fluids, generally done through intravenous lines. Intravenous (IV) lines are tubes that allow fluids, medications, and liquid nourishment to be administered to a patient through a needle-tipped catheter inserted directly into the individual's veins. Once the body is receiving fluids, other injuries such as broken bones or damaged organs can be addressed.

While broken bones and damaged organs can be stabilized in the field, repairing the damage done is typically attempted in a hospital setting. X-rays are used to evaluate the damage done to both internal organs and to bones in order to determine the need for surgery. Careful analysis of the blood also provides information about internal injuries and any adjustments to fluid intake needed to help correct cellular damage. Surgery and other secondary treatments may be postponed until the has healed enough to endure additional stress on the body.

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